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Feminism: Sex and gender discussions

NHS review of adult 'gender' services

89 replies

ArabellaScott · 14/08/2024 09:07

https://www.bmj.com/content/386/bmj.q1788

Starts in September. Headed by Dr David Levy.

'NHS England is carrying out a review of adult gender dysphoria clinics with a remit to explore “broad concerns and issues” reported by “concerned clinicians” during the Cass review of gender identity services for under 18s.
Their concerns reflect similar problems found with services for under 18s, including limited time for assessing patients, expectations that hormones would be prescribed, and lax consent procedures.
The review of adult clinics, announced last week, is expected to last two years and will start in September. It will be led by David Levy, medical director for Lancashire and South Cumbria Integrated Care Board, with support from a panel of expert clinicians, patients, and stakeholders, including representatives of the Care Quality Commission, royal colleges, and professional bodies, NHS England announced in a letter to Hilary Cass, chair of the review of gender identity services for under 18s.1

Adult gender services to be scrutinised after clinicians raise concerns

NHS England is carrying out a review of adult gender dysphoria clinics with a remit to explore “broad concerns and issues” reported by “concerned clinicians” during the Cass review of gender identity services for under 18s. Their concerns reflect simi...

https://www.bmj.com/content/386/bmj.q1788

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NotBadConsidering · 14/08/2024 11:32

It will be interesting to see how they measure outcomes. I see a lot of “Black Knight” attitude in the adult medicalised trans population, like saying they’re completely fine despite someone pointing out their arms have been chopped off.

“I have problems with x, y and X but I’m great, honest!”

It will be important to document the actual problems.

ArabellaScott · 14/08/2024 10:30

Thanks, Faffer. Yes, the link points to a page that has moved. WPATH did have a lot of technical stuff going on for a while.

It's been archived many times showing that it points to the SoC, regardless!

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Faffertea · 14/08/2024 10:25

I’ve just clicked on that GP link to WPATH @ArabellaScott and although the link is still there when you click on it there is now an ‘error 404’ message saying the page can’t be found. Is this WPATH deleting things or just my phone being dodgy?

Interestingly there is a 2 page article in this weeks BMJ about the BMA opposing the Cass review with the usual stuff about marginalised people accessing vital healthcare but there is a quote too at the end from Dr Nick Brown, paediatrician and editor in chief of Archives of Diseases In Childhood defending the research methods of the York group and categorically backing up Cass’ findings.

Nothing mentioned about the letter signed against the BMAs decision but I guess it might have gone to print before that came out.

ArabellaScott · 14/08/2024 10:09

Good to see.

There's a lot of heat and noise around Cass, but worth considering that outwith political noise, clinicians seem to be quietly accepting and acknowledging her work.

A case in point is the BMA's grand declaration of contesting Cass, followed by many members protesting.

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Helleofabore · 14/08/2024 10:01

This will be very interesting, arabella. The adult clinics certainly need to be reviewed.

I look forward to the findings.

What I noticed today was that this has been another impact of the Cass Report. I hope that these reviews that are starting or being asked for bring about positive change.

https://x.com/bernardlane/status/1823548538133029299?s=46&t=HTxp6zCd4GZ2FFv4a-YeQ

Treatment guidelines used by gender clinics in Australian children’s hospitals falsely claim a medical consensus and mislead parents, distressed young people and health professionals in the wider community.

This claim has been put to Australia’s Health Minister Mark Butler by the National Association of Practising Psychiatrists (NAPP), which is calling for an independent federal inquiry, an audit of gender clinic medical records and a centralised registry tracking all minors treated for gender dysphoria.

NAPP president Dr Philip Morris wrote to Mr Butler on August 2, and also sent him a 19-page overview of the gender clinic debate written by Melbourne psychiatrist and researcher Dr Alison Clayton. These two documents went to state and territory health ministers across Australia’s federation on August 12.

This initiative emerged from the NAPP’s July 2 webinar with British paediatrician Dr Hilary Cass on the relevance to Australia of her 2020-24 review of youth dysphoria care.

“While we note that [England’s National Health Service] and the Australian health system are different, the clinical issues regarding gender identity concerns and gender dysphoria in young people are very similar in our two countries,” Dr Morris’s letter to Mr Butler says.

“We consider the general recommendations about the assessment and treatment of youth with gender incongruence and dysphoria by the Cass review are applicable to Australia.”

ArabellaScott · 14/08/2024 09:56

Wondering how they will ensure co operation, given so many clinics refused to even respond to Cass.

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ArabellaScott · 14/08/2024 09:55

https://www.telegraph.co.uk/news/2024/04/12/nhs-trangender-doctor-jonathan-arcelus-male-female-genitals/

https://archive.is/23GAr

'Dr Derek Glidden, who, like Prof Arcelus also works at the Nottingham National Centre for Transgender Health and is its clinical director and is NHS England’s gender dysphoria national speciality adviser, was also criticised after <a class="break-all" href="https://archive.is/o/23GAr/www.telegraph.co.uk/news/2024/04/11/top-nhs-adviser-trans-health-failed-cooperate-cass-review/" rel="nofollow" target="_blank">refusing to share data about his patients with the Cass Review'

'a leading NHS doctor, Jonathan Arcelus, a professor in mental health and transgender health at the University of Nottingham, as among those discussing and endorsing controversial procedures which are currently not allowed on the NHS.

NHS trans clinic doctor backs ‘non standard procedures’ like having both male and female genitalia

Top surgery without nipples, nullification and phallus-preserving vaginoplasty discussed in message board on care for non-binary patients

https://www.telegraph.co.uk/news/2024/04/12/nhs-trangender-doctor-jonathan-arcelus-male-female-genitals

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DeanElderberry · 14/08/2024 09:52

They are beginning to notice that it is going to cost them a fortune in malpractice suits and medical care for survivors.

ArabellaScott · 14/08/2024 09:47

I sure hope they'll be looking closely at why the NHS are still referring and linking to WPATH.

https://ncth.nhs.uk/other-gp-guidance

That page links directly to WPATH's SoC v 8, which includes the section on 'Eunuchs' and links to the Eunuch Archive.

Other GP guidance

There are various places where medical professionals can find details about the treatment of trans and gender diverse individuals.

https://ncth.nhs.uk/other-gp-guidance

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Shortshriftandlethal · 14/08/2024 09:39

I assume detransitioner accounts will also be looked at, as these accounts most often reveal the overwhelmingly affirmative model being pursued by gender cllinicians.

ArabellaScott · 14/08/2024 09:35

'NHS England’s review of adult services will assess not only the quality (i.e. effectiveness, safety, and patient experience) and stability of each service, but also whether the existing service model is still appropriate for the patients it is caring for. The programme of reviews will be led by Dr David Levy, and will carefully consider experiences, feedback and outcomes from clinicians and patients, past and present. The first onsite visits are scheduled to commence in September 2024.'

https://www.england.nhs.uk/long-read/nhs-england-update-on-work-to-transform-gender-identity-services/

NHS England » NHS England update on work to transform gender identity services

https://www.england.nhs.uk/long-read/nhs-england-update-on-work-to-transform-gender-identity-services

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ArabellaScott · 14/08/2024 09:34

'This review will examine the operating procedures in each service; the appropriateness of the service model for the presenting population; areas of concern, and any action being taken to improve quality. It will identify areas for improvement in relation to service quality, good practice that could be shared with other clinics, and any support that should be made available to services to assist improvement.
The key lines of enquiry will be designed in collaboration with current and former patients, clinicians and other key stakeholders.'

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GatherlyGal · 14/08/2024 09:11

This is long overdue.

Adults asking for hormones just seem to get them and there's no where near enough resources to offer therapy alongside so it's just not an option.

I'm not convinced full side effects are communicated properly either.

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